Secondary lymphedema (called lymphedema from here on in the guide) is created by a blockage or disruption of the lymphatic system and often involves the lymph nodes in the groin and armpit area. Usually the cause of the malfunction, such as cancer surgery or radiation therapy, can be identified. Other causes include:
Secondary upper extremity lymphedema is more likely to be due to radiation therapy for breast cancer or axillary lymph node dissection, a procedure used to limit the extent of breast cancer. This is the most common cause of secondary lymphedema. Lymphedema of the lower extremities occurs in 47% of people who undergo genital surgery for cancer, especially if the procedure includes removal of pelvic or groin lymph nodes or radiation therapy. Secondary lymphedema can be divided into acute and chronic type.
Α) Acid Lymphedema
According to the US National Cancer Institute there are four types of acute lymphedema.
The first typeacute secondary lymphedema occurs within a few days after surgical removal of the lymph nodes and is usually mild and transient. This lymphedema usually resolves within 2 or 3 weeks if the limb is kept elevated and the muscles of the limb are frequently contracted .
The second typeacute secondary lymphedema is caused by inflammation of either the lymphatic vessels or the venous vessels. This type can appear 6-8 weeks after surgery or radiation therapy. It is usually treated with elevation of the limb and anti-inflammatory treatment .
The third type acute secondary lymphedema is caused by a minor injury, such as a burn or insect bite that causes infection of the skin and lymph vessels. It is usually treated with elevation of the limb and antibiotics.
The fourth typeacute secondary lymphedema is the most common and develops very gradually, showing symptoms many months or even years after surgery or cancer treatment .
Acute but transient lymphedema typically lasts less than 6 weeks and is characterized by soft skin and pitting, in which the skin leaves a mark when pressed. The impression is common to all swellings and is characterized by a retreat of the skin lasting for a few seconds in response to fingertip pressure. Fluid in the tissues is easily displaced, but as the condition worsens there is no fluid displacement, no impression .
Β) Chronic Lymphedema
This is the most difficult type of lymphedema to treat because the damaged lymphatic system, from the large volume of fluid, cannot respond satisfactorily to treatment. It is often accompanied by changes such as fibrosis. Chronic lymphedema is often associated with :